Individual
JEAN C KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-9555
Mailing address
PO BOX 655-B, 601 ELMWOOD AVE.,, ROCHESTER, NY 14642-8655
(585) 341-3015
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
019949
NY
363AM0700X
Medical Physician Assistant
19949
NY
Other
Enumeration date
06/02/2016
Last updated
06/29/2023
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